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Setting aside the fact that this kind of thing happens at all: How is ketamine the drug of choice?! Although it has a very high active dose:fatal dose (alluded
by xkcd-sucks 6y ago
Setting aside the fact that this kind of thing happens at all: How is ketamine the drug of choice?! Although it has a very high active dose:fatal dose (alluded to in other comments), accepted practice for "chemical restraint" is Thorazine+Valium (or equivalent); ketamine is basically never used for behavioral "sedation" by any medical professional.
- robbiep 6y agoOur Ed takedown drug is midazolam. I can’t see benzos being safe being given by non-medics. The safety profile of ketamine is excellent (as I’m sure you know) Having said that it blows my mind that it is considered necessary or appropriate to give someone ketamine to restrain them.
- jdietrich 6y agoThe use of chemical restraint in a law enforcement setting is an appalling breach of human rights, but ketamine is by far the safest option in an out-of-hospital setting, especially when you don't have any sort of patient history. I'm sure that someone has been killed by a single clinical dose of ketamine, but I'm not sure how. Ketamine isn't a very good chemical cosh, but at least it's a safe one. Anyone administering chlorpromazine and a benzodiazepine in this setting is criminally negligent - if the "patient" (and I very much hesitate to use that word in this context) has taken another CNS depressant, they're in deep trouble.
- sesuximo 6y agoIt’s a candidate for safest only if it’s being used where required by a trained administrator. And those two factors probably outweigh the choice of drug in their effect on lethality.
- nerdbaggy 6y agoIt’s used “a lot” by the EMS. It’s doesn’t lower your blood pressure like Versed can, and ketamine has some pain relief properties.
- dcolkitt 6y agoI would guess the problem is those already intoxicated on opiates, or even alcohol, as many arrestees are. Adding a bento, like valium, to that mix is extremely dangerous because of the synergistic effect on respiratory depression.
- GordonS 6y agoIf you're intoxicated on opioids, you are not going to be violently resisting arrest in the first place.
- pbsds 6y agoNot guaranteed
- GordonS 6y agoNo, it's not guaranteed, it would depend on how intoxicated you were. For the purposes of this discussion, I thought it was safe to assume we were talking about doses that could actually alter your behaviour; high doses of opioids do not make exactly for agresssive behaviour, while lower doses are unlikely to have an impact either way.
- hajwh 6y agoGeorge Floyd was intoxicated on opioids and violently resisting arrest.
- GordonS 6y agoAFAIK, the toxicology report showed tiny amounts of methamphetamine and THC - I don't recall opioids being mentioned at all. A quick Google shows that only in the past few days, the cops are now trying to say he does from a fentanyl overdose, rather than the knee on his neck. TBH, this seems purely like an attempt at scapegoating, making him out to be the "stereotypical black man, crazed on drugs". But we're veering off topic now. I'd rather not discuss the rights and wrongs of the police in this case, because I will disagree hard with any attempts to justify the actions of the police, so there is no interesting discourse to be had there, and HN is not the right platform regardless.
- honksillet 6y agoThe amount of opioids on the streets of the US (and elsewhere) is staggering. Many people are on a cocktail of different street drugs (meth + heroine where I live). You don't want to be adding a benzo like valium to someone who has opioids in their system due to respiratory depression.